FTA-DNA直接提取法在病原真菌分子鉴定中的应用

目的建立并评价FTA-DNA直接提取法在病原真菌分子鉴定中的应用。方法采用whatman FTA-DNA直接提取法从25个不同种属的45株培养的菌株和6例临床标本中提取病原真菌DNA,用于病原真菌的测序鉴定。配制不同浓度的孢子悬液探索该方法的检测限和安全性。结果 45株菌株扩增后均能得到1条清晰的DNA扩增片段,并成功测序。应用该方法亦成功从腹水、胸水、口腔拭子、宫颈拭子来源的临床标本中直接提取DNA并成功鉴定病原真菌。该DNA提取方法联合降落PCR能检测到1.0×103个cell/mL的孢子悬液,1.0×104个cell/mL及以下浓度的孢子悬液可以被FTA卡完全灭活。结论 FTA-DNA直接提取法可快速有效地从培养的菌株及部分临床标本中提取并保存病原真菌DNA,用于病原真菌的测序鉴定。     

连续5年无菌体液标本中分离真菌的鉴定及药敏分析

目的回顾性调查2002-2006年华西医院住院患者无菌体液标本真菌培养的情况,分析真菌菌种及其耐药特点,为临床诊断、治疗提供参考。方法标本接种沙堡弱培养基进行分离培养,采用科马嘉念珠菌显色培养基（CHRO-Ma-gar）和API-20CAUX鉴定系统结合形态学进行菌种鉴定,使用念珠菌药敏试条（ATB-Fungus 2）对2006年来自血液标本中的真菌进行药敏试验。结果2002-2006年间检出的阳性样本数依次为7株、22株、39株、32株及57株;血液来源73株,清洁中段尿来源59株,是主要样本来源;分离真菌以白念珠菌和热带念珠菌为主,占70%以上;2006年血培养中共分离出16株念珠菌,体外药敏情况详见文中。结论临床无菌体液标本中真菌的检出率有逐年上升的趋势;菌株以白念珠菌和热带念珠菌为主,同时近平滑念珠菌、克柔念珠菌、光滑念珠菌、马尔尼菲青霉菌等菌株也有出现;样本来源以血液、清洁中段尿为主;体外药敏总体耐药率低,但是逐渐出现了对氟康唑耐药的白念珠菌和热带念珠菌,应引起高度重视。     

通用PCR法在痰标本真菌检测中的临床应用价值分析

目的:探讨通用PCR法在痰标本真菌检测中的临床应用价值。方法:选择2015年9月至2017年9月本院收治的免疫力低下患者178例作为研究资料,各收集痰标本2份,其中一份用于PCR扩增,另一份经培养后若观察到真菌或可疑菌落,则提取后在此进行PCR扩增测序。比较3种方法对真菌的检出情况、真菌阳性率,与组织病理学结果进行比较,分析3种方法的诊断效能。结果:178份痰标本经平板培养可观察到107份真菌生长,其余71份未见真菌生长。挑取真菌及可疑菌落行PCR结果显示阳性、阴性分别115、63份。对痰标本直接PCR结果显示,阳性、阴性分别124、54份。PCR扩增产物测序结果显示大多是白色念珠菌感染,仅3份是曲霉菌感染。内对照扩增验证结果显示有1份阴性标本存在扩增抑制现象。3种方法的真菌阳性率:直接PCR法痰培养后PCR法痰培养,但组间无显著差异(P0.05)。3种方法诊断效能总体趋势:直接PCR法痰培养后PCR法痰培养,其中直接PCR法与痰培养后PCR法的特异度、准确度均显著高于痰培养法(P0.05),直接PCR法的敏感度显著高于痰培养法(P0.05)。结论:通用PCR法在痰标本真菌检测中的临床应用价值较高,直接PCR具有操作简单、快速等优势。     

哈特草螺菌食源性感染致脓毒症1例

为探讨实验室常规鉴定手段对哈特草螺菌临床分离株的鉴定能力,分析案例患者血液中哈特草螺菌的感染来源,本文使用自动生化鉴定系统、基质辅助激光解吸电离飞行时间质谱(matrix-assisted laser desorption ionization-time of flight mass spectrometer, MALDI-TOF MS)、16S rRNA基因测序和RNA聚合酶的β亚基(rpoB)基因测序对哈特草螺菌进行鉴定,并对患者多部位标本进行哈特草螺菌检测。结果显示,自动生化鉴定系统将哈特草螺菌错误识别为洋葱伯克霍尔德菌,MALDI-TOF MS和16S rRNA基因测序无法鉴别哈特草螺菌、aquaticum草螺菌或camelliae草螺菌,rpoB基因测序可以准确将其鉴定为哈特草螺菌;除血液外,仅在患者粪便中检出少量哈特草螺菌,血液和粪便来源的哈特草螺菌肠杆菌基因间重复共有序列聚合酶链反应(enterobacterial repetitive intergenic consensus polymerase chain reaction, ERIC-PCR)结果显示,两者的DNA...     

急诊重症监护室患者与社区健康人群肠道假丝酵母构成的比较与分析

本研究旨在分析社区正常人群与急诊重症监护室(intensive care unit,ICU)患者肠道假丝酵母(又称念珠菌)的组成,比较两组人群肠道念珠菌构成的差异。2014年5-7月,收集1 732名上海社区健康人群的粪便标本;2014年2月-2015年1月,收集191名上海交通大学医学院附属瑞金医院急诊ICU患者的粪便或肛周拭子标本。经真菌培养收集单个菌落,通过内转录间隔区(internal transcribed spacer,ITS)序列分析进一步鉴定菌种,分析两组人群肠道定植真菌的组成特点。结果显示,社区健康人群的肠道标本中检测到9种念珠菌,定植率为13.16%;同时有两种和三种念珠菌定植的比例分别为3.81%和0。急诊ICU患者肠道标本只检测到5种念珠菌,但定植率高达37.17%;同时有两种和三种念珠菌定植的比例分别为9.95%和2.09%。社区健康人群和急诊ICU患者肠道中常见念珠菌分别为白念珠菌(5.25% vs. 27.23%)、光滑念珠菌(5.83% vs. 13.61%)、热带念珠菌(0.52% vs. 7.33%)、近平滑念珠菌(4.16% vs. 2.09%)、Candida metapsilosis(1.10% vs. 1.05%)。结果显示,急诊ICU患者的肠道念珠菌定植率显著高于社区人群(P<0.001),同时有两种(P＝0.001)和三种(P<0.001)念珠菌定植的比例也显著高于社区人群。这种肠道念珠菌的高度定植及多重定植可能增加急诊ICU患者发生念珠菌感染的概率。     

基于ITS2高通量测序 研究强直性脊柱炎患者肠道真菌特征

目的探究强直性脊柱炎(ankylosing spondylitis,AS)患者肠道真菌菌群的多样性特征,分析健康人群与AS患者肠道真菌的结构差异。方法收集17例健康人群新鲜粪便样本和24例AS患者新鲜粪便样本,分别称为HC组和AS组,提取两组粪便样本总DNA;根据真菌ITS2区设计引物进行扩增,利用Illumina HiSeq PE250平台进行ITS2高通量测序;测序结果经过Reads拼接,OTUs(operational taxonomic units)聚类,Alpha和主成分分析,物种组成统计,显著性差异分析,最终得到样本物种信息。结果对肠道真菌菌群进行Alpha分析,各多样性指标中,shannon和observed_species指数差异有统计学意义(P0.05),其余指数差异均无统计学意义,故不能明确两组间多样性的差异。主成分分析提示差异显著。对肠道真菌结构进行分析,门的水平分析显示,担子菌门(Basidiomycota)在HC组和AS组中差异显著,接合菌门(Zygomycota)在两组间差异极显著;纲和属的水平分析显示,Ascomycota_unidentified纲在两组中差异显著,伞菌纲(Agaricomycetes)、Incertae_sedis_10纲、Orbiliomycetes纲差异极显著。Agaricomycetes_unidentified_1属、Amphinema属、Geoglossales_unidentified_1属、腔块菌属(Hydnotrya)差异显著,鹅膏菌属(Amanita)和锁瑚菌属(Clavulina)差异极显著。结论本实验证实了在AS患者中存在肠道真菌菌群失调,其特征是生物多样性和结构的改变,揭示肠道真菌也可能在AS发病中发挥作用。     

肝硬化合并肺部感染的病原菌分布及危险因素分析

目的:分析肝硬化合并肺部感染的病原菌分布及危险因素。方法:选取2013年2月到2018年7月期间我院接受治疗的肝硬化患者518例,统计所有患者中并发肺部感染的例数,收集患者的临床资料,包括性别、年龄、病因、住院时间、是否有侵入性操作、是否有腹水、Child-Pugh分级、是否有上消化道出血、是否有合并基础疾病等临床资料,分析肺部感染与患者的各项临床资料的关系,并检测肝硬化合并肺部感染的病原菌分布情况,采用多因素Logistic回归分析肝硬化患者发生肺部感染的危险因素。结果:518例肝硬化患者中有80例发生肺部感染,发生率为15.44%。单因素分析显示,性别与肝硬化患者发生肺部感染无关(P0.05),年龄、病因、住院时间、侵入性操作、腹水、Child-Pugh分级、上消化道出血、合并基础疾病均是肝硬化患者发生肺部感染的影响因素(P0.05)。多因素Logistic回归分析显示,年龄芏60岁、住院时间芏2周、有侵入性操作、有腹水、Child-Pugh分级为C级、有上消化道出血、合并基础疾病均是肝硬化患者发生肺部感染的危险因素(P0.05)。80例肝硬化患者合并肺部感染患者的痰液标本中共检出病原菌93株,其中革兰阴性菌51株,占比54.84%,革兰阳性菌37株,占比39.78%,真菌5株,占比5.38%。结论:肝硬化合并肺部感染的主要病原菌为革兰阳性菌和革兰阴性菌,且肺部感染的危险因素较多,临床上应根据其危险因素做好相对应的防治措施,以减少肺部感染的发生。     

10年肠道真菌培养结果分析

目的探讨浙江大学医学院第一附属医院住院患者肠道真菌分离状况与趋势变化。方法回顾分析2000年1月1日至2009年12月30日10年间在该院送检的住院患者粪便标本的真菌分离率、真菌种类和年度变迁变化特点。结果 10年间从送检全部疑似肠道真菌感染的2 344份粪便标本中共检到真菌1 456株,归属5属19种,每年的检出率在55.7%67.0%。分离菌株中以白色念珠菌（74.0%）占首位,其次是光滑念珠菌（11.4%）,再次是热带念珠菌（7.1%）,光滑念珠菌和热带念珠菌分离率分别从2000年的4.9%、6.6%上升到2009年的16.8%、10.6%,呈上升趋势。结论该院10年间肠道真菌的分离率较高,白色念珠菌的分离率一直位于首位,非白色念珠菌的分离率处于上升趋势。     

基于锁核酸及等位位点特异性扩增技术的KRAS基因突变检测荧光定量PCR方法研究

基于等位位点特异性扩增的原理,设计锁核酸修饰KRAS基因突变特异性扩增引物,结合封阻探针技术,建立检测KRAS基因突变的荧光定量PCR方法。结果发现,锁核酸修饰的引物及探针可显著提高等位位点特异性扩增技术用于复杂样本中的微量基因突变检测的敏感度,该技术检测KRAS基因突变的敏感性可达0.01%~0.1%。进一步用建立的荧光定量PCR方法检测52例结直肠癌患者血浆标本,并用DNA测序法作为对照,同时用健康人血浆标本建立阴性检测结果判读标准,以初步评价该方法应用于循环DNA中KRAS基因突变检测的可行性。结果发现结直肠癌患者KRAS基因突变主要是G12C、G12A和G12R,而且q PCR法的阳性检出率为46.15%,高于DNA测序法(13.46%),阴性结果与DNA测序法的符合率为100%。此外,结直肠癌患者外周血KRAS基因的突变检出率与文献报道组织标本中的突变检出率及常见突变类型基本相符。上述结果说明该方法检测循环肿瘤DNA(circulating tumor DNA,ct DNA)具有较高的可靠性,可以用于肿瘤患者循环血液中KRAS基因突变的检测。     

培菌白蚁菌圃和粪便微生物多样性分析

【背景】培菌白蚁是属于白蚁科的一类与鸡枞菌属真菌共生的高等白蚁,其与体内肠道微生物和体外菌圃微生物形成三维共生体系。【目的】分析培菌白蚁菌圃和粪便的微生物多样性,并与肠道微生物进行比较。【方法】通过Illumina MiSeq高通量测序方法对培菌白蚁菌圃和粪便样品进行细菌16S rRNA基因和真菌ITS测序分析。【结果】高通量测序获得培菌白蚁菌圃和粪便样品细菌和真菌的有效序列和OTU数目。5个样品细菌OTU数目在90-199之间,而真菌OTU在10-58之间,细菌的种类多样性明显大于真菌。不论是细菌还是真菌,粪便样品的OTU数目多于菌圃样品。经物种分类分析,菌圃样品主要优势细菌是变形菌门(Proteobacteria),其相对含量超过82.4%;其次是拟杆菌门(Bacteroidetes)和厚壁菌门(Firmicutes);粪便样品中优势细菌为拟杆菌门,其次是变形菌门,粪便优势菌属为别样杆菌属和营发酵单胞菌属,这与培菌白蚁肠道菌多样性组成一致。培菌白蚁菌圃和粪便样品共生真菌主要为担子菌门(Basidiomycota)和子囊菌门(Ascomycota)。菌圃优势真菌为鸡枞菌属(Termitomyces),相对含量在51.83%以上,菌圃中还鉴定到炭角菌属(1%,Xylaria)。【结论】为今后培菌白蚁-体内外微生物共生关系研究以及微生物的分离培养提供了依据和参考。     

Massive parallel 16S rRNA gene pyrosequencing reveals highly diverse fecal bacterial and fungal communities in healthy dogs and cats

This study evaluated the fecal microbiota of 12 healthy pet dogs and 12 pet cats using bacterial and fungal tag-encoded FLX-Titanium amplicon pyrosequencing. A total of 120,406 pyrosequencing reads for bacteria (mean 5017) and 5359 sequences (one pool each for dogs and cats) for fungi were analyzed. Additionally, group-specific 16S rRNA gene clone libraries for Bifidobacterium spp. and lactic acid-producing bacteria (LAB) were constructed. The most abundant bacterial phylum was Firmicutes, followed by Bacteroidetes in dogs and Actinobacteria in cats. The most prevalent bacterial class in dogs and cats was Clostridia, dominated by the genera Clostridium (clusters XIVa and XI) and Ruminococcus. At the genus level, 85 operational taxonomic units (OTUs) were identified in dogs and 113 OTUs in cats. Seventeen LAB and eight Bifidobacterium spp. were detected in canine feces. Ascomycota was the only fungal phylum detected in cats, while Ascomycota, Basidiomycota, Glomeromycota, and Zygomycota were identified in dogs. Nacaseomyces was the most abundant fungal genus in dogs; Saccharomyces and Aspergillus were predominant in cats. At the genus level, 33 different fungal OTUs were observed in dogs and 17 OTUs in cats. In conclusion, this study revealed a highly diverse bacterial and fungal microbiota in canine and feline feces.     

Ascites Bacterial Burden and Immune Cell Profile Are Associated with Poor Clinical Outcomes in the Absence of Overt Infection

Bacterial infections, most commonly spontaneous bacterial peritonitis in patients with ascites, occur in one third of admitted patients with cirrhosis, and account for a 4-fold increase in mortality. Bacteria are isolated from less than 40% of ascites infections by culture, necessitating empirical antibiotic treatment, but culture-independent studies suggest bacteria are commonly present, even in the absence of overt infection. Widespread detection of low levels of bacteria in ascites, in the absence of peritonitis, suggests immune impairment may contribute to higher susceptibility to infection in cirrhotic patients. However, little is known about the role of ascites leukocyte composition and function in this context. We determined ascites bacterial composition by quantitative PCR and 16S rRNA gene sequencing in 25 patients with culture-negative, non-neutrocytic ascites, and compared microbiological data with ascites and peripheral blood leukocyte composition and phenotype. Bacterial DNA was detected in ascitic fluid from 23 of 25 patients, with significant positive correlations between bacterial DNA levels and poor 6-month clinical outcomes (death, readmission). Ascites leukocyte composition was variable, but dominated by macrophages or T lymphocytes, with lower numbers of B lymphocytes and natural killer cells. Consistent with the hypothesis that impaired innate immunity contributes to susceptibility to infection, high bacterial DNA burden was associated with reduced major histocompatibility complex class II expression on ascites (but not peripheral blood) monocytes/macrophages. These data indicate an association between the presence of ascites bacterial DNA and early death and readmission in patients with decompensated cirrhosis. They further suggest that impairment of innate immunity contributes to increased bacterial translocation, risk of peritonitis, or both.     

Initial fungal colonizer affects mass loss and fungal community development in Picea abies logs 6 yr after inoculation

Picea abies logs were inoculated with Resinicium bicolor, Fomitopsis pinicola or left un-inoculated and placed in an old-growth boreal forest. Mass loss and fungal community data were collected after 6 yr to test whether simplification of the fungal community via inoculation affects mass loss and fungal community development. Three techniques were used to survey communities: (1) observation of fruiting structures; (2) culturing on media; and (3) cloning and sequencing of ITS rDNA. Fruit body surveys detected the smallest number of species (18, 3.8 per log), DNA-based methods detected the most species (72, 31.7 per log), and culturing detected an intermediate number (23, 7.2 per log). Initial colonizer affected community development and inoculation with F. pinicola led to significantly greater mass loss. Relationships among fungal community composition, community richness and mass loss are complex and further work is needed to determine whether simplification of fungal communities affects carbon sequestration in forests.     

Comparison of fungal communities among ten macrophyte rhizospheres

The fungal community composition, size and several physico-chemical properties were individually investigated in ten macrophyte rhizospheric substrates using nested PCR-denaturing gradient gel electrophoresis and soil chemical methods. Results indicated that both Dothideomycetes and Sordariomycetes were dominant fungi in macrophyte rhizospheric substrates, and denitrifying fungi (Fusarium graminearum) was found in nine of ten macrophyte rhizospheres. Fungal Shannon-Wiener diversity index (H) and richness (S) in Thalia dealbata, Typha latifolia, Iris hexagona and Hemerocallis aurantiaca rhizospheres were higher than those in other six rhizospheres. Fungal number and biomass were 1.91 × 10³ CFUs g^?1 dw and 1.53 μg ergosterol g^?1 dw in Iris pseudacor rhizosphere, and were greater than in other nine rhizospheres. The correlation analysis showed that fungal number and biomass significantly and positively correlated to total soil phosphorus, while fungal H and S were significantly and negatively correlated to total organic carbon. The principal components analysis (PCA) showed that the fungal community significantly divided ten macrophyte rhizospheres into four groups, showing the significant difference of fungal communities among ten rhizospheric substrates. The current study revealed for the first time the importance of rhizospheric fungal community in distinguishing macrophyte rhizospheres, thus will undoubtedly widen our insight into fungal communities in aquatic rhizospheres.     

Analysis of factors of pulmonary fungal infection in mice in respiratory medicine department based on logistic regression analysis model and Progranulin

The objective of this research is to solve the current medical problems of a high incidence of fungal infections in the lungs, high misdiagnosis rate, and high mortality. In this study, firstly, the logistic regression model was used to conduct. Risk factors of pulmonary fungal infection in respiratory department were analyzed. Then a model of pulmonary fungal infection in mice was constructed, and the expression difference of Progranulin (PGRN) in serum was detected by enzyme-linked immuno sorbent assay (ELISA). The expression of PGRN in lung tissues of mice infected by pulmonary fungi was detected by Western bolt method and quantitative polymerase chain reaction (PCR). The PGRN protein and mRNA expression in the lung epithelial cells of mice were detected after the infection. Results logistic regression model was used to analyze the main risk factors affecting pulmonary infection in mice. The risk factors of pulmonary fungal infection were indent catheter, hypoproteinemia, long-term use of glucocorticoid and long-term use of antibiotics. The PGRN content in serum was obviously higher than that before pulmonary fungal infection (P < 0.01). The expression of PGRN mRNA and protein in lung tissue was obviously higher than that before infection (P < 0.01). The expression of PGRN mRNA and protein in lung tissues of the infected group was obviously higher than that of the non-infected group (P < 0.01). The expression of PGRN protein in the lung epithelial cells of mice was obviously higher at 24 h after infection than before infection (P < 0.01), and the expression of PGRN mRNA was obviously higher at 12 h after infection than before infection (P < 0.01), indicating that PGRN is highly expressed in fungal pulmonary infection and is involved in disease progression. Therefore, this study provides a new idea for the diagnosis and treatment of fungal pulmonary infection in the later stage and has a good guiding significance for the diagnosis and treatment of fungal pulmonary infection.     

Bacterial and fungal co-infections among COVID-19 patients in intensive care unit

This study aimed to investigate the frequency and characteristics of respiratory co-infections in COVID-19 patients in the intensive care unit (ICU). In this retrospective observational study, pathogens responsible for potential co-infections were detected by the bacterial culture, real-time polymerase chain reaction (RT-PCR), or serological fungal antigen tests. Demographic and clinical characteristics, as well as microbial results, were analyzed. Bacterial culture identified 56 (58.3%) positive samples for respiratory pathogens, with the most common bacteria being Burkholderia cepacia (18, 18.8%). RT-PCR detected 38 (76.0%) and 58 (87.9%) positive results in the severe and critical groups, respectively. Most common pathogens detected were Stenotrophomonas maltophilia (28.0%) and Pseudomonas aeruginosa (28.0%) in the severe group and S. maltophilia (45.5%) in the critical group. P. aeruginosa was detected more during the early stage after ICU admission. Acinetobacter baumannii and Staphylococcus aureus were more frequently identified during late ICU admission. Fungal serum antigens were more frequently positive in the critical group than in the severe group, and the positive rate of fungal serum antigens frequency increased with prolonged ICU stay. A high frequency of respiratory co-infections presented in ICU COVID-19 patients. Careful examinations and necessary tests should be performed to exclude these co-infections.     

Exploring antifungal activities of acetone extract of selected Indian medicinal plants against human dermal fungal pathogens

A broad spectrum of medicinal plants was used as traditional remedies for various infectious diseases. Fungal infectious diseases have a significant impact on public health. Fungi cause more prevalent infections in immunocompromised individuals mainly patients undergoing transplantation related therapies, and malignant cancer treatments. The present study aimed to investigate the in vitro antifungal effects of the traditional medicinal plants used in India against the fungal pathogens associated with dermal infections. Indian medicinal plants (Acalypha indica, Lawsonia inermis Allium sativum and Citrus limon) extract (acetone/crude) were tested for their antifungal effects against five fungal species isolated from skin scrapings of fungal infected patients were identified as including Alternaria spp., Curvularia spp., Fusarium spp., Trichophyton spp. and Geotrichum spp. using well diffusion test and the broth micro dilution method. All plant extracts have shown to have antifungal efficacy against dermal pathogens. Particularly, Allium sativum extract revealed a strong antifungal effect against all fungal isolates with the minimum fungicidal concentration (MFC) of 50–100 μg/mL. Strong antifungal activity against Curvularia spp., Trichophyton spp., and Geotrichum spp. was also observed for the extracts of Acalypha indica, and Lawsonia inermis with MFCs of 50–800 μg/mL respectively. The extracts of Citrus limon showed an effective antifungal activity against most of the fungal strains tested with the MFCs of 50–800 μg/mL. Our research demonstrated the strong evidence of conventional plants extracts against clinical fungal pathogens with the most promising option of employing natural-drugs for the treatment of skin infections. Furthermore, in-depth analysis of identifying the compounds responsible for the antifungal activity that could offer alternatives way to develop new natural antifungal therapeutics for combating resistant recurrent infections.     

Detection of fungal spores from contaminated surfaces by the polymerase chain reaction

A method has been developed to detect fungal spores in dust samples collected from internal surfaces of air-conditioning ducts. The method is based on the utilization of the polymerase chain reaction (PCR) with specific primers for fungal species. PCR amplification is carried out directly in boiled samples avoiding time-consuming DNA preparation steps. The presence of bovine serum albumin in the reaction mixture overcame the inhibitory effect of the humic acids present in the dust.     

灵芝孢子粉在真菌性肠炎所致腹泻中的应用

目的了解真菌性肠炎所致腹泻的菌种分布特点,探索灵芝孢子粉对其的治疗效果。方法将110例腹泻患者的粪便直接涂片革兰染色镜检。查见较多真菌孢子和菌丝者进行分离鉴定,并采用灵芝孢子粉治疗。结果110例腹泻患者中查见真菌孢子及菌丝者62例;真菌分布白色假丝酵母菌占56．45％,克柔假丝酵母菌占16．13％,热带假丝酵母菌占14．52％,近平滑假丝酵母菌占6．45％,季也蒙假丝酵母菌占6．45％,用灵芝孢子粉治疗真菌性肠炎所致腹泻21d后有效率为96．77％。结论真菌性肠炎所致腹泻以白色假丝酵母菌感染为主,应用灵芝孢子粉治疗方法简单、安全、有效。     

深部真菌感染临床特点分析

目的了解深部真菌感染患者的性别、年龄、感染部位、住院科室、菌种分布及真菌耐药情况,为临床防治真菌感染提供研究依据。方法收集荆州市中心医院2009年1月至2009年12月微生物实验室分离的真菌446株,采用科马嘉显色琼脂及API220C Aux鉴定系统鉴定,并使用ATMTMFUNGUS3真菌药敏卡进行体外药敏试验。结果临床真菌感染男性占72%,以老年患者为主,大于60岁者占54.9%;感染的真菌主要分布于呼吸内科和ICU,分别占35.5%、24.9%;主要感染部位为呼吸道,占91.3%;主要菌种为白假丝酵母菌、热带念株菌、近平滑假丝酵母菌、光滑念株菌和克柔念株菌,分别占64.2%、13.2%、9.6%、7.6%和5.4%;合并细菌感染的感染真菌100株,占22.2%,细菌中以革兰阴杆性菌为主,占96%;药敏试验结果显示真菌对各抗真菌药具有较好的敏感性。结论临床真菌感染已日益突出,以呼吸科及ICU患者老年男性为主,儿童真菌感染亦不容忽视,感染菌种以白假丝酵母菌和热带念株菌为主,临床应加强对这些真菌感染的预防和监测,防止真菌感染。